基于定量与质性分析的医疗机构控烟效果及影响因素研究

Study on the Effect of Tobacco Control and Its Influence Factors Based on Quantitative and Qualitative Analysis

目的了解医疗机构的控烟干预效果,对影响医疗机构无烟环境创建效果的主要因素进行分析,并提出改进意见。方法设计调查问卷,了解天津市津南区辖区内控烟干预工作实施情况;采用T检验、Kruskal-Wallis检验分析干预前后医疗机构的得分差异性;采用logistic多因素分析影响医疗机构创建无烟环境的主要因素。结果控烟政策干预前后,各评分维度的得分均有所提升;干预前后,门诊部、个体诊所和乡镇卫生院在医疗机构无烟环境制度建设、医务人员控烟行为与认知得分存在差异(P<0.05),民营医院、门诊部和个体诊所患者对于无烟环境评价在干预实施前后存在差异(P<0.05);同时设置室外吸烟区、控烟宣传材料发放和公布控烟监督电话,定期开展控烟培训、吸烟和被动吸烟危害认知及提供戒烟服务等均为影响总体得分的主要因素。结论通过对控烟干预措施实施前后对比分析和影响因素评价,结合对相关责任人的访谈结果,提出完善禁烟立法、加强控烟工作的执行力度、强化内外部监督协同机制、提升医务人员控烟认知水平和积极宣传控烟知识等完善措施,以保证医疗机构无烟环境创建工作进一步深化完善。

OBJECTIVE To understand the medical and health institutions of tobacco control intervention effect, affecting the medical and health institutions a smoke-free environment to create the effect of main factors analysis, and put forward improving opinion; METHODS It designed questionnaire to understand the implementation of tobacco control interventions. The difference of scores of medical institutions before and after the intervention was analyzed by t-test and kruskal-wallis; using logit multifactor analysis, the main factors affecting the creation of smoke-free environment in medical institutions were analyzed. RESULTS The scores of the scoring dimensions were raised before and after the smoking control policy intervention; before and after the intervention, outpatient department individual clinics and townships in the construction of a smoke-free environment system of medical institutions, medical personnel control behavior and cognitive scored differences （P〈0.05）, civilian battalion hospital, clinic and individual clinic patients for a smoke-free environment evaluation in the differences before and after the intervention （P〈0.05）; At the same time set the outdoor smoking area, smoking control distribution of publicity materials, announced the tobacco control supervision of telephone, regularly carried out training about tobacco control, smoking and passive smoking hazard cognition, providing services and so on were the main factors influencing the overall score; CONCLUSION Through the comparative analysis before and after the tobacco control intervention measures and factors influencing the evaluation, in combination with the relevant person in the interview. It suggest, to consummate the anti-smoking legislation, strengthen the enforcement of tobacco control, strengthen internal and external supervision and coordination mechanism, enhance the level of medical personnel control cognitive, positive and perfect measures knowledge about tobacco control, so as to ensure the medical institutions create work deepening perfecting a smoke-free environment.